Preceptor Tips with DJ Gilliland

Preceptors are an important part of the MAT program for future Athletic Trainers. Dr. DJ Gilliland shares what makes a good

Preceptor Tips

Call out by name a few of the best preceptors you have known.

David Stuckey at Hardin Simmons – instilled in us the desire to give back to the profession.

It was our responsibility to mentor someone

David Colt or DC hired me out of undergrad. He guided us on how to teach and interact with our students.

Kyle Southall at Briarwood Christian in Alabama

48 local preceptors

Dustin Rush – What you see is what you get

He does a great job of letting students take chances and risks.

Dustin has a fantastic debrief with the students.

Frank Perez – He is a tough preceptor with a ton of experience.  He is really good.

He spent several years with Cirque De Soleil and brings dance medicine into the equation

He has a large administrative component to his site.

  • Great communication skills with coaches and admin, and team docs
  • He is an alumnus
  • Always an ear to listen or a shoulder to guide them…we need to guide them more

Administrative work:

  • Documentation practices are on par with what is needed for professional communication
  • Team management – day-to-day injury report presentations
  • Working alongside the nutritionist for the team
  • Physician referrals
  • Scheduling
    • Second-year students should be involved with scheduling and communicating with the opponents' medical staff.
    • 5% of the BOC is now about Administration
    • Allow the MAT students to schedule the student coverage
    • Teach them how to manage the student aides
    • Allow them to create an evaluation system
    • Have them look at and update the policies and procedures.
    • Have them look at and update the EAP
    • Teach them to be a mentor to the kids
    • Understanding professional boundaries

Mike Ramirez – 

  • “You can not work in the NFL unless you work at a college”
  • Great with organization and teaching the students what to expect.
  • He puts students in charge of making sure the gear is ready
  • They learn inventory
  • Real-world problem solving
  • Writing rehab plans

Brenna Ellis

She transformed the experience for our students. They leave feeling like they have grown as an individual and professionals.

AT is a family.

Supervised Autonomy – 

The preceptor should be the patient's advocate

Build up the student's trust and confidence by having mock scenarios in downtime.

The really good preceptors take advantage of that time.

  • EMS situations
  • Knowing the rules of the sport
  • Use the scaffolding approach to build trust
  • Give them more freedom in lower-pressure situations first.
  • Give them a comfortable environment to fall forward

From the students:

JP: I felt like my hands were being held the whole time… I was either setting up the field or observing.

JP: One preceptor gave us printed steps for taping. So we could use them during independent practice

JP: Having a written plan for the athletes to follow helps us grow, but also gives me the opportunity to develop a plan.

Contact Us

Jeremy Jackson

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

Amy Metiva, snocross, HOIST

Cryotherapy Research with Sean Kennedy

Cryotherapy Research discussion with Sean Kennedy, live from the Memorial Hermann Sports Medicine Update. What is current science telling us?

Cryotherapy research

Cryotherapy – What do you tell them?

We have a lot of interpretations, so it makes it hard for there to be clear guidance

Cryo after injuries – there is no hard science about dosing for ice

Think about the messaging (chemical and nerve) that may be delayed

There is a place to allow the swelling to do its job.

Evidence shows compression edges out ice but can be used together easily.

Listen to the theories and allow your mind to be open. Do not be a stagnant clinician.

Cold water emersion

We used to believe it would send them into shock and the heat would stay in the core

All position statements say full body immersion is the standard to lower core temperature

Joint application only could take 80 minutes to cool the body

It could be 3-5 minutes with cold water immersion

Cryotherapy Recovery from workout

What is the value of reducing the perceived soreness from the damage that was done?

If you are trying to mask the fatigue by ice bath you are increasing the risk of injury.

Contact Us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

Instead of Icing try MarcPro

Marc Pro

Supply Chain Concerns for 2023

Supply chain issues are still causing problems for Athletic Trainers. Thankfully Paul Calloway has the inside scoop to help us stay ahead of it.

Supply Chain Concerns 2023 with Paul Calloway

AEDs – there has been a shortage for a little while.

Shortage in components and an uptick with purchasing after Damar Hamlin incident

Hospital suppliers have more access than sports medicine suppliers

Aerosols 

Tough to get – QDA, Tuff Skin, Adhesive, Cold Spray

  • All are unavailable for the foreseeable future possibly until 2024.
  • Magic spray and stick em’
  • May not be available in as many varieties

Shortages cause price increases

M-tack from Mueller is a pump spray

Gatorade chews 

Still in short supply

They have basically taken those out of the options

Cliff bar energy chew is an alternative

Foam

There has been a bit of pressure in the foam market.

Pre-wrap and under wrap continue to be problems for sourcing

Price increases should be expected

Looking at about $1 per roll

OTC meds 

More so with Medique brand products

They have been struggling for about 2 years to get things leveled out.

You may need to buy in the bulk bottle

Athletic Tape

Coach tape from J&J was bought by BSN Medical

The price has gone up but it is back and available again.

Elasticon has been brought back as well

Zonas 1-inch box tape is back in production as well.

Other concerns

There tends to be consolidation of SKUs…like there may be fewer options for ankle braces

Mueller has discontinued some of the medkit lines.

Not a whole lot of new products out this year

Prices will continue to generally increase

Freight

We are paying more in freight now than last year.  Even if it says free shipping, it still has to come out of the costs.

Tips

If there are a few sacred items put no substitutions but be willing to consider alternatives on most other products.

Andover was bought by Millican…they are the same, but just now switching branding

They did discontinue some of the niche items

Contact Us

Jeremy Jackson

Paul Calloway – Twitter or Facebook

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

Marc Pro

Patellar Instability

Patellar Instability is a specialty for Dr. Jeremy Rush's orthopedic practice in San Antonio.

Tell me about the first patellar instability you remember seeing.

Chronic instability up to dislocation

It is a very heterogeneous group

Patella dislocation and patella subluxation

And patella instability

Addressing the first-time dislocator

Be super aggressive with the rehab

Step one: reduce the dislocation

Brace them for a week but then get them moving

Try to get started in PT within one week

See them back about 6 weeks and then again at 3 months

At 6 weeks with effusion makes you think there is a loose body.

Ability to do straight leg raises

Apprehension with manual pressure

Instability vs dislocation.

Dislocation = all the way out – 95% are lateral

  • Usually traumatic events
  • Some are from anatomic risk factors

Subluxation is partially out of the groove

Instability is a chronic form of Subluxation

First timer tips

Get them to relax

Move them into extension

Calm them and even cover the dislocation if needed

Maybe get them up and it could self-reduce

Top patient complaints/ indicators of patellar instability

Knee feels unstable or it is slipping

Or my knee just hurts

Buckling

Recurrent effusion

Anterior knee pain

Start with rehab

Target

Positive patellar apprehension

J-Sign

Predisposed to instability

Patella alta

Women are at higher risk due to q-angle hyperlaxity

Rotational abnormalities

On exam

J-sign

Apprehension

Lateral pressure

MRI on chronic instability

MPFL damage

If the injury is unclear then I get an MRI to rule out any sort of cartilage or loose body.  

A huge effusion indicates a loose body.

Contact:

Dr. Jeremy Rush – IG @satxsportsmedicine

Jeremy – @jhjacksonlat

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

Amy Metiva, snocross, HOIST

Eccentric vs Tempo

Eccentric contractions have long been known to improve muscle hypertrophy. Ryan Collins joins Clayton Berrang to discuss Eccentrics vs Tempo training and how to implement both.

Eccentric vs tempo

Where in the timeline are the athletes?

Once they can move without bracing

Strength Deficit Eccentric training benefits

Supermaximal load and trying to move that through the eccentric motion

A load that can not move through the concentric movement

How would you recommend emphasizing eccentric training?

Tempo training is a safe place to start but it affects the muscle adaptations

Most ATs and PTs are probably already doing this.

EX: single leg squat – box progression – 

Reverse engineer sprinting

Brakes are going to be important to anything we move

But eccentric training offers so much more than just the brakes

Triphasic training

When do you transition from eccentric training?

Time of year and sports demands

Talk about the cycles for football

Summer is great for super maximal loads for the experienced lifters

Beginners lifted should be doing triphasic

The full stretch-shortening cycle would be in season

Tempo training is one of the easiest forms of progression for an athlete's body

Most adaptations from the eccentric load

Increased reps give some adaptations

Tempo is the lowest ROI

Box squats example

Tempo training and progress through the tempo training

4×5 with a 3 sec – 4-5 and up to 8-second tempo

Now we use slightly heavier weight with about a 2-second tempo

5 – 7 – 10 – 12 reps progression

Progress through load

4×5 and increase the load over the next 4 weeks

How do we set up a supermaximal eccentric?

Rack setup with safety catches and partners or team lift it back up

We are looking at 5/10% above our maximal level

We can do 5 sets of 1

Is there a tempo in this eccentric?

Move it as slowly as possible

The nordic hamstring curl is an example

“What works works”

If you move slowly you will move slow, move fast to move fast”

Late RTP 6 months out ACL?

Overload plays in

Their body is avoiding positions needed for power due to injury.

Post activation potentiation

Bands are a great tool

Apply them in multiple planes of motion.

You can pull them into an overloaded position

Forward-backward lunge with the band

Clayton Berrang – Email cberraang@athleteth.com

Contact Us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

BOC after 50

Contact Us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

TikTok

Mobilization of the Athletic Spine

Mobilization of the Athletic spine with Brian Duncan and Shawn Ready live at the Memorial Hermann Sports Medicine Update

Mobilization of the athletic spine

Who is worried about spine manipulation?

My fear is always the lack of proper evaluation

You need all the myotomes, dermatomes, mobility, and descriptions.

You are not going to manipulate someone who just went in for a tackle and is now having pain.

Red flags are more obvious, but what about yellow flags of mobilization?

Going through your 5Ds

Dysphasia

Dysarthria

Dysoplia

Dizziness

Drop attack

3Ns

Nystagmus

Nausea

Manipulation is a skill similar to any special test we do… it's like an anterior drawer

HVLA manipulations

High-Velocity Low Amplitude

Knowing your anatomy is crucial if you are going to do mobilizations.

Contact Us

Brain Duncan – 214-632-6784

Contact Us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

ATCornerPodcastATCornerds@gmail.com

Joseph Eberhardteberhardtj@pearlandisd.org

Christina Fry – fryc@pearlandisd.org

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

mobilization HOIST

How It Ended

Jamie shares How It Ended, an amazing partnership between AT and AD to transform the culture of sports medicine in a community.

How It Ended
Phot credit: https://jamiekaywoodall.wordpress.com/

Jamie, go back over the timeline.

DME – I wanted to be in the high school setting so I knew DME was short term

A&M Consolidated – 2 years, then I left to be the head AT, open a new school, and work alongside my husband.

Rudder in Bryan ISD 11 years – AT and public health mirror each other in the area of prevention. I felt called to go into public health and work with low socioeconomic status.  We housed a few homeless students during our time there. During the master's, I got connected with HR and the school safety department. Felt like I hit a ceiling and thought it may be because we were married and did not want to put a spouse in charge of the other.

The move to Brenham would really challenge me to grow.

Assistant AD of Sports Med in Bryan ISD

Brenham – 4 years

Waller ISD

Coach Allen, where are you now?

Giddings Texas – DC / Head AT

Houston Stratford HC/CC – 16 years

Head AD in Benham because we wanted to retire

Bastrop allowed me to be just the AD not a coach anymore.

What is the legacy y’all left?

Coach Allen – Do what is best for kids, even if it is tough for adults.

Jamie – I would hope people would see how deeply I care about making the whole system.

I hope that through my work, people would see that we win when there is a team approach.

You discussed the talks at SWATA and NATA, what do you want to clarify?

The AT department needed a lot of tender loving care.

When I got into I realized how much prep work I needed to do.

Use the PASS or SSSA to guide you and make sure you evaluate your program

I was in the middle of getting my hands dirty and realized I did not have sinks.  Coach Allen came in and made it happen within a few days. 

Coach Allen, speak to the AT, how do they start the process of building what y’all built?

A lot of times there is a natural divide between the 2

Athletic Trainers are fearful the coach won’t listen and follow instructions

Coaches are fearful every player will be set out.

Be willing to pitch in and do the extra things.

Build trust

Call to action:

ATs – try not to take on responsibilities that are not yours and then let it become your job or expected of you.

If I did someone else's job, I would remind them to take care of it.

Jamie is one of the most efficient people I know.  She handles people and situations really well.  

She went out and earned the changes and I was able to go in and ask for it.

Contact Us

Jeremy Jackson

Eliot Allen – dallen2@bisdtx.org

Jamie Woodall – jwoodall@wallerisd.net

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

How It Ended
Frio Hydration

Medical Screening with Dr. Laura Purdy

Dr. Luara Purdy goes over what we know at this point about Damar Hamlin and the importance of accurate medical history.

Dr. Laura Purdy

Dr. Purdy, what do we know at this point about Damar Hamlin?

Has a background of sickle cell trait

Almost no commentary of known information about his heart.

He suffered sudden cardiac death and was resuscitated

Usually, the athlete has something leading up to an episode with hypertrophic cardiomyopathy

Underwent induced hyperthermia and was put into a coma

If there are not any problematic findings he could be cleared to play again and perform rehab.

Any inaccurate info out there we can help correct?

COVID virus and vaccine – causes mild carditis

COVID is not the only virus or vaccine that causes this.

The heart is a muscle and our bodies are filled with muscles from head-to-toe

Most viruses cause inflammation of muscles.

The flu makes your whole body hurt…muscles.

Myocarditis hurts every time your heart beats

A colleague had a kid turn in a physical without documentation of being insulin dependent. What are your thoughts?

This is so dangerous – everyone involved needs to be aware and know how to deal with the possible complications.

They need to have insulin available and food available all the time.

WE WAN YOU TO PLAY…safely

Dr. Purdy, what are some non-reported medical conditions that cause problems?

Asthma

Anaphylaxis

Any history of previous injury

Head injuries

Vision

Discuss the sports physical versus a routine / developmental physical.

Most athletes are going to feel healthy

A routine annual physical is designed to take a look at your health head to toe and risk factors.

We have limited time with them during this.

By having a sports physical we give two opportunities for the doctor to see the patient. And the sports physical would be scheduled for more time.

Telehealth – 

The physical exam would change the outcome

We do have smart stethoscopes but we are not there yet.

Still get your sports physical in person if at all possible

Offload the other visits to telehealth and free up the doctor for more in-person time

Athletic Trainers are the first line of defense in protecting the athletes.

If you see something please say something.

Contact Us

Jeremy Jackson

Dr. Laura Purdy –

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

The Good Life

The Good Life, relationships are built, trust is established and culture is changing. Jamie and Eliot discuss what the AT / AD relationship looked like once they got past the rough spots.

Good Life

Coach Allen, what has been your favorite part about working with Jamie?

She is such a problem solver. She anticipates problems that are going to occur.

Jamie, Your favorite part about working with Coach Allen?

Very patient and graceful when things do not go his way.

He did not shut down when I came on too strong.

“Is it best for the kids?” is a driving force for him

What was your biggest sports medicine victory together?

When I first got into it I wanted to do a lot but I had to clean and organize everything first.

I knew I was going to forget something big like AEDs.

Bart Peterson had a checklist he shared with Jamie that was part of the PASS system.

This really helped us prevent compliance slip-ups.

We changed the culture of healthcare in Brenham.  The ripple effect. 

The overall respect our community and school had for ATs

We built up to having 4 ATs.

Parents and students were asking for it. 

What are some of your smaller wins?

  • I needed a window door if I had to have a closed-door conversation.
  • Hydration systems – moved away from trash cans
  • Radios
  • Lockers for student ATs
  • We shut down the gym AT and moved everything to the field house AT Facility.
  • Having the plan written out on the whiteboard allowed us to collaborate more.

Any regrets?

Coach Allen – Not really, have not worked with anyone I trusted as much as Jamie.

I came in too strong.

When I left Brenham it was an unexpected change.  It was not something I was looking for and therefore was a little unprepared.

There were some organizational things I had not prioritized because of the bigger issues.

Talk about the Master’s Degree

I got my degree in public health because I was ready to leave the profession.

Through the master’s I learned how happy I was in the profession

In Brenham, I did not have time for all the school health stuff while we were making adjustments.

The pandemic was really a blessing for an AT with a degree in public health.  Being married to Josh Woodall helped us really sit down and work side by side and help set up procedures to get stuff back to the school and back to athletes.

The leadership team was meeting and Coach Allen knew Jamie would be a great asset.  He pressured the admin to let her in.

Delivery is key

Respect is built and given, not taken

We did Character Talks with our athletes to help grow the respect for the AT staff.  Jamie spoke at some of them.

Contact:

Jamie Woodall  – jwoodall@wallerisd.net

Eliot Allen – dallen2@bisdtx.org

Jeremy – @MrJeremJackson on Twitter

These people LOVE Athletic Trainers and help support the podcast:

Frio Hydration – Superior Hydration products.

Xothrm – Best heating pad available – Use “SMB” or email info@xothrm.com and mention the Sports Medicine Broadcast

Donate and get some swag (like Patreon but for the school)

HOIST – No matter your reason for dehydration DRINK HOIST

MedBridge Education – Use “TheSMB” to save some money, be entered in a drawing for a second year free, and support the podcast.

Marc Pro – Use “THESMB” to recover better.

Athletic Dry Needling – Save up to $100 when registering through our link.

FrioHydration; frio hydration; Get Frio; Best in class; Waterboy; wisstech; hydration station; sports medicine broadcast; Jeremy Jackson; Rob McFarlin